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Table 1 Themes common to more successful PTs and themes unique to less successful PTs

From: Impact of peer-trainer leadership style on uptake of a peer led educational outreach intervention to improve tuberculosis care and outcomes in Malawi: a qualitative study

Themes Common Among More successful PTsDescription of Theme
Flexible• More successful PTs reported to be flexible in their approach to training, including a willingness to adjust timing of sessions and/or to provide additional group or individual sessions to accommodate LHWs personal and/or professional schedules
Role Model• More successful PTs were noted to role model the intervention approach with patients, and in some cases to see patients with trainees early during training in order to model the approach
Supportive Supervision• More successful PTs noted to provide supportive supervision with constructive feedback provided to individuals and shared with the group to support learning
Proactive
• Addressing challenges
• Collaborative planning
• More successful PTs were noted to address anticipated challenges at the start of implementation, by providing a detailed introduction to the intervention, and openly discussing challenges and LHW concerns
• More successful PTs were reported to plan collaboratively including LHWs at their site in developing a training and implementation plan
Perseverant
• Continued efforts to engage LHWs
• Engage support and advice to address challenges
• More successful PTs were noted to persevere through challenges as they arose through the course of implementation, this included continuing efforts to engage LHWs who initially declined to participate and offering additional sessions for LHWs who initially declined to participate and for LHWs transferred in after the initial training.
• More successful PTs were also noted to engage support and advice from leadership at their health centre and/or other PTs from their district
Knowledgeable• More successful PTs were reported to be knowledgeable about TB and the intervention, with LHW trainees reported their PT as a resource for addressing questions and issues as they arose
Supportive• Morse successful PTs were noted to provide supportive supervision both through constructive criticism and sharing learning’s from patient encounters/issues with the LHW TB team, and by making themselves available in person and/or by phone to provide consultation and guidance
Themes unique to less Successful PTs
 Poor attitude• Some less successful PTs were noted to be unwilling to provide some or all the training despite interest from LHWs at their site
 Passive-avoidant• Some less successful PTs were noted to avoid discussion of potential or actual challenges, and to create barriers to training and implementation as a result, others denied facing any implementation challenges until challenges were revealed through study team site visits